G. Personal Health and Critical-Incident Stress


This section provides a guide to recognizing and meeting common physical and emotional problems encountered during disaster relief activities. Experience has shown that promoting and main-taining good health, especially by coping with the stresses encountered overseas, are the keys to successful performance.

1. Briefings

The most important key to personal health and safety is to follow briefings given by OFDA, the State Department, the DART Team Leader, the USAID Mission in-country, the U.S. Embassy or Consulate in-country, and affected-country contacts. They can provide up-to-date details on disease, sanitation, food and water safety, personal and property security, and other information to keep team members healthy and safe during the assignment.

Team members should never knowingly put their lives in jeopardy. "Stay alert, keep calm, think clearly, and act decisively" should be their motto. Tasks should be accomplished by putting safety first.

2. Managing Culture Shock

Team members may experience two different but related types of stress. The first is culture shock, which comes from suddenly being placed in a foreign environment. The second is the emotional and physical impact that often comes from being immersed in a disaster.

Between arriving in-country and reaching the disaster site, team members may experience classic culture shock. The team member is a foreigner and may be frustrated because of an inability to communicate with the local population; anxiety and frustration may erode his or her customary level of self-confidence.

The team member should expect to be disoriented and confused and realize that this response is natural and often happens to others in similar situations. Patience, realistic expectations of an ability to make a difference, and a sense of humor are good coping strategies in these circumstances. The team member should not expect the affected country and the victims to change their ways of doing things to accommodate relief workers.

3. Critical-Incident Stress

No one who sees a major disaster remains emotionally untouched by it. Typical reactions are feelings of frustration, hopelessness, that simply too much suffering exists, and one person can have relatively little impact.

The combined effects of cultural stress and job stress make team members vulnerable to physical and emotional exhaustion. Some people refer to this condition as "burnout." It can happen to anyone.

The disaster-related stress caused by these factors is often referred to as critical-incident stress (CIS). A critical incident is any incident so unusually stressful to an individual as to cause an immediate or delayed emotional reaction that surpasses available coping mechanisms. Critical incidents take many forms, including all emergencies that cause personnel to experience unusually strong reactions.

The effects of critical incidents can include profound behavioral changes that may occur immediately or may be delayed for months or years.

4. How Team Members May Be Affected by Stress During Disaster Operations

Following are some ways team members may be affected by stress during disaster operations.

  • They may experience physical symptoms associated with stress, such as headache, upset stomach, diarrhea, poor concentration, and feelings of irritability and restlessness.
  • They may become overwhelmed by the disaster and prefer not to talk about it, think about it, or even associate with coworkers during time off. They may become tired of con-tinual interaction with victims and may want to isolate themselves during time off.
  • They may have feelings of frustration or guilt because they miss their families and are unavailable to their families physically and emotionally due to fatigue, their involvement in the disaster, and so forth.
  • They may feel frustrated with family and friends when they are able to contact them because the relief workers feel that families and friends simply cannot understand the disaster experience. If family and friends become irritated, it can compound the problem, and temporary isolation and estrangement may occur.

5. How To Minimize Stress During a Disaster Operation

Following are some ways to minimize stress during a disaster operation.

  • As much as possible, make living accommodations personal and comfortable. Mementos from home may help disaster workers to keep in touch psychologically.
  • Exercise regularly consistent with your present physical condition and the limitations of the disaster site and try to relax with some activity away from the disaster scene.
  • Get enough sleep and try to eat regular meals, even if you are not hungry. Avoid foods high in sugar, fat, and sodium. Taking vitamin and mineral supplements may help your body to continue to get the nutrients it needs.
  • Avoid excessive use of alcohol and coffee. Caffeine is a stimulant and should be used in moderation because it affects the nervous system, making relief workers nervous and edgy.
  • Although you need time alone on long disaster operations, spend time with coworkers. Both experienced and new relief workers should spend rest time away from the disaster scene. Talking about normal things (home, friends, family, hobbies, etc.) other than the disaster is a healthy change of pace.
  • Use humor to help ease the tension. Use it carefully, however, as victims or coworkers can take things personally, resulting in hurt feelings if they are the brunt of "disaster humor."
  • When on the job, take breaks during the day, especially if you find yourself making mistakes or are unable to concentrate.

Team members should try to stay in touch with family back home if they can. Communication helps prevent the sense of being strangers when they return after the disaster.

Team Leaders can take specific, practical action to prevent and reduce the effects of CIS, consequently avoiding the personal and organizational costs associated with treatment. Steps include:

  • Learning to identify and respond to CIS in personnel.
  • Educating team members in advance about the potential harmful effects of critical incidents.

Experiencing stress during a disaster operation is normal, but remember that stress can be identified and managed.

TOC: General Responsibilities and Information